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Objectives. To define Patient Acceptable Symptom State (PASS) thresholds
for the Oxfordhipscore (OHS) and Oxford knee score (OKS) at mid-term
follow-up. Methods. In a prospective multicentre cohort study, OHS and OKS were collected
at a mean follow-up of three years (1.5 to 6.0), combined with a
numeric rating scale (NRS) for satisfaction and an external validation
question assessing the patient’s willingness to undergo surgery
again. A total of 550 patients underwent total hip replacement (THR)
and 367 underwent total knee replacement (TKR). Results. Receiver operating characteristic (ROC) curves identified a PASS
threshold of 42 for the OHS after THR and 37 for the OKS after TKR.
THR patients with an OHS ≥ 42 and TKR patients with an OKS ≥ 37
had a higher NRS for satisfaction and a greater likelihood of being
willing to undergo surgery again. Conclusions. PASS thresholds appear larger at mid-term follow-up than at six
months after surgery. With- out external validation, we would advise
against using these PASS thresholds as absolute thresholds in defining
whether or not a patient has attained an acceptable symptom state
after THR or TKR. Cite this article: Bone Joint Res 2014;3:7–13